Regional Variation in Diabetic Outcomes by Country-of-Origin and Language in an Urban Safety Net Hospital
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Adherence to diabetic care guidelines among US immigrants remains low. This study assesses adherence to diabetic care guidelines by country-of-origin and language among a limited English-proficient (LEP) population. Timely completion of diabetic measures and acceptable levels of hemoglobin A1c (A1c), low density lipoprotein (LDL) cholesterol, and blood pressure (BP) were compared between LEP and English-proficient (EP) patients in this 2013 retrospective cohort study of adult diabetics. More LEP patients met BP targets (83 vs. 68 %, p < 0.0001) and obtained LDL targets (89 vs. 85 %, p = 0.0007); however, they had worse LDL control (57 vs. 62 %, p = 0.0011). Ethiopians and Somalians [adjusted OR (95 % CI) = 0.44 (0.30, 0.63)] were less likely than Latin Americans to meet BP goals. LEP patients outperformed EP peers on several diabetic outcomes measures with important variation between groups. These data highlight the success of a safety net hospital in improving diabetes management among diverse populations.
KeywordsDiabetes Limited English language proficiency Immigrant Interpreter use
This study was funded by the Robert D. and Patricia E. Kern Mayo Clinic Center for the Science of Health Care Delivery.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Danaei, G., Finucane, M. M., Lu, Y., Singh, G. M., Cowan, M. J., Paciorek, C. J., et al. (2011). National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. The Lancet, 378(9785), 31–40.CrossRefGoogle Scholar
- 6.Chew, L. D., Schillinger, D., Maynard, C., Lessler, D. S., & Consortium for Quality Improvement in Safety Net Hospitals. (2008). Glycemic and lipid control among patients with diabetes at six US public hospitals. Journal of Health Care for the Poor and Underserved, 19(4), 1060–1075.CrossRefPubMedGoogle Scholar
- 8.Ryan, C. (2013). Language use in the United States: 2011. Washington, DC: US Census Bureau. (Accessed September 17, 2014).Google Scholar
- 16.Schenker, Y., Karter, A. J., Schillinger, D., Warton, E. M., Adler, N. E., Moffet, H. H., et al. (2010). The impact of limited English proficiency and physician language concordance on reports of clinical interactions among patients with diabetes: The DISTANCE study. Patient Education and Counseling, 81(2), 222–228.CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Fernandez, A., Schillinger, D., Warton, E. M., Adler, N., Moffet, H. H., Schenker, Y., et al. (2011). Language barriers, physician-patient language concordance, and glycemic control among insured Latinos with diabetes: The Diabetes Study of Northern California (DISTANCE). Journal of General Internal Medicine, 26(2), 170–176.CrossRefPubMedGoogle Scholar
- 21.Minnesota Community Measurement. (2015). 2014 Health Equity of Care Report: Stratification of Health Care Performance Results in Minnesota by Race, Hispanic Ethnicity, Preferred Language, and Country of Origin. Retrieved from http://mncm.org/wp-content/uploads/2015/01/2014-MN-Community-Measurement-Health-Equity-of-Care-Report-part-1.pdf.
- 22.Minnesota Community Measurement. (2014). Data collection guide: Optimal diabetes care 2014 (01/01/2013 to 12/31/2013 Dates of Service). Retrieved from http://mncm.org/wp-content/uploads/2014/01/Optimal_Diabetes_Care_2014-Final-12.19.2013.pdf.